Improving Surgical Outcomes With Early Physical Therapy After Anterior Cervical Discectomy and Fusion
Vanderbilt University Medical Center
Summary
The goal of this two-group randomized clinical trial is to examine the effects of early postoperative PT compared to delayed postoperative PT for improving outcomes after hospital discharge for ACDF surgery. The main question this clinical trial aims to answer are: * Whether early PT participants will demonstrate greater improvements in outcomes compared to delayed PT participants. * Whether improvements in handgrip strength, cervical endurance, and cervical range of motion will be associated with improvements in outcomes. Participants will be randomized to one of two groups (early PT or delayed PT) and outcomes compared across groups.
Description
This study is a prospective randomized controlled trial of early PT (within 3 months after surgery) versus delayed PT (greater than 3 months after surgery) in adults following ACDF surgery for degenerative conditions. The central hypothesis is that an early PT program will be effective in improving disability, pain, physical function, opioid use and return to work/duty. 76 participants will be enrolled and randomized (38 patients per randomized group), with 64 (85%) expected to be retained in the trial at the 12-month follow-up. Eligible patients undergoing ACDF surgery for a degenerative cond…
Eligibility
- Age range
- 18–75 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Surgical treatment of a cervical degenerative condition using a 1- or 2-level ACDF procedure; * English speaking due to feasibility of employing study personnel to deliver and assess the study intervention; and * Age 18-75 years of age (individuals older than 75 are more likely to experience respiratory and nervous system complications and death following ACDF) Exclusion Criteria: * Surgery secondary to trauma, fracture, tumor, infection, or spinal deformity; * Undergoing cervical corpectomy; * Prior history of cervical spine surgery in last 5 years; * Diagnosis or pre…
Interventions
- OtherEarly PT
Physical therapy delivered within the first three months after surgery.
- OtherDelayed PT
Physical therapy delivered greater than 3 months after surgery.
Locations (4)
- Tripler Army Medical CenterHonolulu, Hawaii
- Vanderbilt University Medical CenterNashville, Tennessee
- Booke Army Medical CenterFort Sam Houston, Texas
- Madigan Army Medical CenterTacoma, Washington